Preface

At a personal level, everyone recognises the importance of good quality sleep. From a medical perspective, however, only recently has the potential adverse impact of a disordered sleep–wake cycle on cognitive, mental and even physical health been realised. The consequences of excessive daytime sleepiness are also increasingly defined, especially with respect to driving and other potentially dangerous activities. Perhaps surprisingly, the precise biological reasons why every animal has a basic need for regular sleep are still speculative and the fascinating state of rapid eye movement (REM) sleep remains a particular enigma. However, it is abundantly clear that sleepiness is a true drive state and, ultimately, as important as hunger or thirst for optimal health and survival. Partly because it cuts across numerous more established specialities, the emerging discipline of sleep medicine remains in its infancy and is generally poorly addressed in medical schools. As a consequence, many physicians in primary and secondary care lack confidence in addressing sleep-related symptoms, despite significant advances in our understanding and treatment options for the majority of sleep disorders over the last decade. A further confound is a widely held and mistaken belief that sleep disorders invariably require complex and expensive techniques for confident diagnosis. With the exception of sleep-related breathing disorders, the majority of sleep disorders can actually be adequately managed without an absolute need for detailed investigations…